Axel Helmer

A Service Oriented Platform for Health Services and Ambient Assisted Living

Providing health care and assistance at home becomes more and more important due to the aging society and - in general - a health system under financial pressure. It is generally accepted that these services have to be supported by an eHealth infrastructure that enables the exchange of patient related data between different health institutions and assistance systems athome (referred to by the term AAL). In this paper a service-oriented architecture for delivering eHealth / AAL services at home using a hardware platform such as a residential gateway or a set-top-box is proposedand exemplified by three different services: (1) telerehabilitation of patients after heard surgery, (2) support of hearing impaired people and (3) the monitoring of Activities of Daily Living (ADL).

The Lower Saxony research network design of environments for ageing: towards interdisciplinary research on information and communication technologies in ageing societies

Worldwide, ageing societies are bringing challenges for independent living and healthcare. Health-enabling technologies for pervasive healthcare and sensor-enhanced health information systems offer new opportunities for care. In order to identify, implement and assess such new information and communication technologies (ICT) the ‘Lower Saxony Research Network Design of Environments for Ageing’ (GAL) has been launched in 2008 as interdisciplinary research project. In this publication, we inform about the goals and structure of GAL, including first outcomes, as well as to discuss the potentials and possible barriers of such highly interdisciplinary research projects in the field of health-enabling technologies for pervasive healthcare. Although GALs high interdisciplinarity at the beginning slowed down the speed of research progress, we can now work on problems, which can hardly be solved by one or few disciplines alone. Interdisciplinary research projects on ICT in ageing societies are needed and recommended.

Information and communication technologies for promoting and sustaining quality of life, health and self-sufficiency in ageing societies – outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL)

Many societies across the world are confronted with demographic changes, usually related to increased life expectancy and, often, relatively low birth rates. Information and communication technologies (ICT) may contribute to adequately support senior citizens in aging societies with respect to quality of life and quality and efficiency of health care processes. For investigating and for providing answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, the Lower Saxony Research Network Design of Environments for Ageing (GAL) had been established as a five years research project, running from 2008 to 2013. Ambient-assisted living (AAL) technologies in personal and home environments were especially important. In this article we report on the GAL project, and present some of its major outcomes after five years of research. We report on major challenges and lessons learned in running and organizing such a large, inter- and multidisciplinary project and discuss GAL in the context of related research projects. With respect to research outcomes, we have, for example, learned new knowledge about multimodal and speech-based human–machine-interaction mechanisms for persons with functional restrictions, and identified new methods and developed new algorithms for identifying activities of daily life and detecting acute events, particularly falls. A total of 79 apartments of senior citizens had been equipped with specific “GAL technology”, providing new insights into the use of sensor data for smart homes. Major challenges we had to face were to deal constructively with GAL’s highly inter- and multidisciplinary aspects, with respect to research into GAL’s application scenarios, shifting from theory and lab experimentation to field tests, and the complexity of organizing and, in our view, successfully managing such a large project. Overall it can be stated that, from our point of view, the GAL research network has been run successfully and has achieved its major research objectives. Since we now know much more on how and where to use AAL technologies for new environments of living and new forms of care, a future focus for research can now be outlined for systematically planned studies, scientifically exploring the benefits of AAL technologies for senior citizens, in particular with respect to quality of life and the quality and efficiency of health care.

3DLC: A Comprehensive Model for Personal Health Records Supporting New Types of Medical Applications

Motivated by the demographic change, many new medical applications are installed in the users home environment. These applications make use of ambient sensors, enabling new forms of medical care. Personal Health Records (PHRs) are an instrument for the storage, presentation and communication of health related data provided by these applications. But there are still open issues regarding the cooperation between PHRs and the new applications. On the basis of two medical application scenarios, we developed a new model which defines the appropriate level of abstraction of data generated by medical applications to be stored inside the PHR. The model also determines which part of these data is relevant for the clinical decision making process, and how these data should be communicated to physicians. This paper describes the 3DLC model, which uses three dimensions (clinical decision, frequency and context dependence) to determine the type of the data. We further introduce a prototype PHR system that is able to fulfil the requirements of our scenarios.

A sensor-enhanced health information system to support automatically controlled exercise training of COPD patients

For an improvement of the quality of life for patients suffering from chronic obstructive pulmonary disease (COPD) we developed a concept and prototype of a sensor-enhanced health information system. This system includes a component that is monitoring the rehabilitation training and automatically controls the target load for the exercise on the basis of his or her vital data. The system also detects potentially critical health states and communicates alarms to external users. The component interacts with a personal electronic health record (PHR) that provides additional health related information for the decision making process, as feedback to the user and as an opportunity for physicians to optimize the users exercise plan. The PHR uses current medical informatics standards to store and transmit training data to health care professionals and to provide a maximum of interoperability with their information systems. We have integrated these components in a service oriented platform design that is located in the home environment of the user.

A technical platform for environments for ageing--lessons learned from three field studies.

The Lower Saxony Research Network “Design of Environments for Ageing” (GAL) studied possible applications of assistive technology for enabling older adults to live longer and independent in their own home. As part of this work, a technical platform was developed as a common technical basis for all assistive systems in the project. This article presents an overview of the architecture and core functionality of the technical platform, which in the first generation was developed for use in a laboratory setting, and in a second generation was extended for use in the project’s field studies, i.e. prototype installations in end-users homes. The field studies’ primary objective was the evaluation of the assistive technologies, that were developed within the overall project. However, these studies also confirmed that the fundamental concept of the technical platform is valid, and the prototypes continuously worked 24 h a day for several months. However, there were some problems related to lack of infrastructure in the older adults’ homes and human factors such as inadvertent placement of objects across sensors’ field of view, acceptance problems due to aesthetical reasons or simply communication problems, which show that making complex technologies work for users with little technical experience is well possible, but requires a careful consideration of the complete service chain and related “soft factors”.

Intelligent environments supporting the care of multi-morbid patients: a concept for patient-centered information management and therapy

Evermore people are suffering from multi-morbidity, an accumulation of different afflictions that mutually affect each other. Simultaneously treatments which were previously conducted stationary are nowadays carried out in home settings. Therefore more and more ICT is employed to support such treatments. However, most of these systems are isolated and not accounting for technical interoperability or the determining factor that different treatments influence each other. An approach for an integrated system to treat multi-morbid patients is presented within this paper. It aims to join various means of monitoring, health data storage and telemedicine into a holistic system to account for the needs of such patients. Already implemented subsystems are presented and considerable advantages of the system under construction are illustrated by a use-case for its application.

Working with a domestic assessment system to estimate the need of support and care of elderly and disabled persons: results from field studies

This article describes the results of field studies performed over a period between five months and 24 months. The objectives of these studies were to collect long-term real-life data to evaluate how these data can be mapped to items on standardized assessment tests and which presentation method is most suitable to inform caregivers about critical situations and changes in health or care needs. A Home-monitoring system which uses modern sensor technologies was developed for and used in these field studies. It was installed in living environments of seven people (three who were not in need of care, two in need of care, and two with mental disabilities). The data were generated by sensor data acquisition and questionnaire reporting. Four types of data analysis and representation were evaluated to support caregivers. Results show that sensor data can be used to determine information directly or indirectly, which can be mapped to relevant assessment items and presented with different degrees of granularity. It is also feasible to determine and present additional information of potential interest which cannot be directly mapped to any assessment item. Sensor data can also be displayed in a live view. This live data representation led to a decrease in the caregivers’ workload when assessed according to the German version of the Perceived Stress Questionnaire.

A system for the model based emergency detection and communication for the telerehabilitation training of cardiopulmonary patients

Cardiopulmonary diseases affect millions of people and cause high costs in health care systems worldwide. Patients should perform regular endurance exercises to stabilize their health state and prevent further impairment. However, patients are often uncertain about the level of intensity they should exercise in their current condition.

Automated determinination of head gaze in rodents

Behavioral experiments to determine the sensory performance of mice or rats often require the measurement of the animals head gaze. Nevertheless, commercial systems for video tracking of laboratory animals are often restricted to tracking of the body position and sometimes the nose position, leading to defective estimates of the gaze direction or require several artificial markers. Most experimenters rely on subjective judgments of this important experimental measurement. In this study we present three algorithms to determine the exact gaze of freely moving rodents. Two of these algorithms rely on artificial markers which are attached to the animals head. One approach uses knowledge about the body shape of rodents to track gaze without the use of artificial markers. All three algorithms determine the direction of gaze more precisely than a human observer and avoid systematic errors occurring in previously available tracking algorithms.